Eradication of Chlamydia trachomatis parallels symptom regression in chronic bacterial prostatitis patients treated with a fluoroquinolone-macrolide combination.

To investigate the association between eradication of Chlamydia trachomatis (CT) and symptom regression in chronic prostatitis, 55 symptomatic patients were subjected to segmented tests to localise CT in first voided urine (VB1), prostatic secretions (EPS), post-massage voided (VB3) or semen specimens. Patients were divided in three treatment groups: the 'urethral involvement' group ('U': VB1 positive, EPS/VB3/Semen negative) was treated with 500 mg day(-1) azithromycin for 3 days. The 'prostatitis' group ('P': VB1 negative, EPS/VB3/semen positive) with 4-week levofloxacin-azithromycin combination. A third group, 'U+P' (VB1, EPS/VB3/semen positive) received both treatments in sequence. In P patients, eradication of CT was paralleled by marked, sustained symptom improvement and by significant decrease of serum prostate-specific antigen (PSA) levels. Compared with U patients, undergoing rapid regression of symptoms related to painful micturition after short-term azithromycin, U+P patients showed symptom and pathogen persistence in VB3/EPS/semen and required additional treatment with 4-week levofloxacin-azithromycin to achieve pathogen eradication, symptom regression, and decrease of PSA. Our results support a causative role of CT in chronic bacterial prostatitis. In the presence of a positive urethral localisation of the pathogen, thorough microbiological investigation together with focused symptom analysis may reveal an underlying chlamydial prostatitis and direct effective therapy with appropriate antibacterial agents.

In-vitro postantibiotic effects of miocamycin and erythromycin on gram-positive cocci.

The capability of miocamycin to induce a postantibiotic effect (PAE) on a Group A Streptococcus beta-haemolyticus clinical isolate and on Staphylococcus aureus ATCC 29213 has been studied. Erythromycin was chosen as a reference molecule. The exposure time to antibiotics was 90 min. The removal technique of the antibiotic agents consisted of a 1:200 dilution in cultural broth. Miocamycin displayed a PAE of 2 h 30 min in relation to the minimum inhibitory concentration (MIC) of Streptococcus and a PAE of 2 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 5 h 40 min towards Streptococcus and of 4 h 18 min towards Staphylococcus at a concentration eightfold the MIC. Erythromycin showed a PAE of 1 h 36 min in relation to the MIC of Streptococcus and a PAE of 1 h 30 min in relation to the MIC of Staphylococcus. The PAE value lasting longer than the others was of 3 h 15 min against Streptococcus and of 2 h 30 min against Staphylococcus at a concentration eightfold the MIC. In some cases a PAE was observed in relation to subinhibitory concentrations (1/2 MIC). Miocamycin therefore proved to possess a more evident capability to induce a PAE against the clinical isolate of Group A Streptococcus beta-haemolyticus and on Staphylococcus aureus ATCC 29213 than did erythromycin.

[Validity limits of data on secretory IgA]. / Limiti della validità dei dati relativi alle IgA secretorie.

Secretory IgA (sIgA) in saliva, and sometimes in expectoration, have been titrated in various groups of persons, both in pediatric age and in adults, by means of radial immunodiffusion technic. The aim was to find differences among sIgA levels in the course of respiratory tract infections, both acute and chronic, in consequence of treatment with Erythromycin (in children and in adults) in consequence of surgical intervention (in adults). Adjunctive aim was to establish if it was possible to recognize hereditary of the character that remark the predisposition to produce high sIgA quantities. The very high variability of the data collected in the various occasions and situations allowed serious doubts about the possibility of use of the parameter sIgA in saliva for the evaluations that were assumed as aim of the research. The said high variability was confirmed in a single surely healthy boy, in which sIgA were performed on saliva specimens collected for ten consecutive days, morning and evening, always at the same time (8 a.m. and p.m.). In the attempt to clarify the reason of such a variability, the intervention of psychical solicitation and emotional conditions were ipotized to modify production, mobilization and secretion of IgA generally considered and sIgA particularly.

[Clinical use of latex tests. II. Evaluation of latex tests in C-reactive protein determination]. / L'impiego clinico dei tests al lattice. II. Valutazione dei metodi al lattice per la determinazione della proteina C reattiva (PCR).

We compared the most reliable and practical laboratory methods for the quantitative determination of serum C-reactive protein that is polistyrene latex particles together with purified anti-C-reactive protein rabbit globulin, the precipitation test using anti-C-reactive protein serum and finally, radial immunodiffusion on agar-gel plates. We examined 163 serum specimens from ambulatory patients and from various hospitalized patients in Istituti Clinici di Perfezionamento of Milan (Italy). All the methods tested showed a good qualitative discrimination for serum C-reactive protein presence or absence at pathological levels. We also compared the two latex methods. In conclusion, radial immunodiffusion confirmed to be the best method for accurate C-reactive protein dosage during inflammatory and degenerative processes.

[The clinical use of latex tests. I. Comparison of hemolytic and latex methods in the evaluation of the antistreptolysin antibody titer]. / L'impiego clinico dei tests al lattice. I. Confronto tra metodi emolitici ed al lattice nella valutazione del titolo anticorpale antistreptolisinico (TAS).

The TAS of 211 normo lipemic patients and of 84 hyperlipemic patients has been determined by the tube dilution hemolysis method of Rantz and Randall, the Aso Quantum hemolytic method (I.S.V.T. "Sclavo" S.p.A., Siena) and methods with streptolysin O antigen coated on the surface of biologically inert latex particles. A good correlation has been shown between all the analytical techniques considered and, moreover, the incidence of wrong positives and negatives has been showed in comparison with the hemolytic method by Rantz and Randall, considered test of reference. Finally, the greater influence of cholesterol on the classic hemolytic system, compared with the latex technique in causing an unspecific increase of TAS is proposed; this is evaluated before and after treatment of the hyperlipemic samples with ether.